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Indian Journal of Anesthesia and Analgesia

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The Influence of Tranexamic Acid on Platelet Function in Patients Undergoing Open Heart Surgery Using Cardiopulmonary Bypass (CPB)

Vidyadhar Ketavath, Resident, Dept of Anesthesiology and Intensive care, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana 500082, India. , Geeta Kanithi1 , Vidyadhar Ketavath2 , Srinivas Mantha3 , R. Gopinath4

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Indian Journal of Anesthesia and Analgesia 4(4):p 1006-1012, October-December 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.15

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Abstract

Introduction: Platelet dysfunction is consideredto be a major cause of bleeding after cardiac surgery following tranexamic Cardiopulmonary Bypass (CPB), resulting in an increased need for transfusions. Lysine analogues such as  acid, inhibit fibrinolysis by attachment to the lysine binding sites on plasminogen and plasmin and prevent fibrinolysis by blocking engagement of these fibrinolytic proteins with fibrinogen and fibrin. Aim: In this study, we sought to determine whether Regimen 1 (continuous infusion of tranexamic acid) preserves platelet function when compared to Regimen2 (bolus dose of tranexamic acid). Material and Methods: Regimen1 Tranexamic acid 10mg/kg IV after induction before skin incision followed by 1mg/kg/hr infusion. Regimen2 Tranexamic acid 10mg/kg IV after induction before skin incision followed by 5mg/kg bolus in pump prime and 5mg/kg IV after protamine administration. Results: There was no statistically significant difference between the two groups or within the same group at different time periods with regard to platelet aggregation. Conclusion: Either continuous or intermittent methods of tranexamic acid in patients undergoing open heart surgery may be used for pharmacological prophylaxis for bleeding.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.15

Keywords

CPB; Tranexamic Acid; Platelet Aggregation. 

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